RESUMO
Objective: This study aimed to survey the practice of palliative sedation in Portugal, where data on this subject were lacking. Methods: This was a prospective multicentric study that included all patients admitted to each team that agreed to participate. Patients were followed until death, discharge, or after 3 months of follow-up. Results: The study included 8 teams: 4 as palliative care units (PCU), 1 as a hospital palliative care team (HPCT), 2 as home care (HC), and 1 as HPCT and HC. Of the 361 patients enrolled, 52% were male, the median age was 76 years, and 285 (79%) had cancer. Continuous sedation was undergone by 49 (14%) patients: 26 (53%) were male, and the median age was 76. Most patients, 46 (94%), had an oncological diagnosis. Only in a minority of cases, the family, 16 (33%), or the patient, 5 (10%), participated in the decision to sedate. Delirium was the most frequent symptom leading to sedation. The medication most used was midazolam (65%). In the multivariable analysis, only age and the combined score were independently associated with sedation; patients <76 years and those with higher levels of suffering had a higher probability of being sedated. Conclusions: The practice of continuous palliative sedation in Portugal is within the range reported in other studies. One particularly relevant point was the low participation of patients and their families in the decision-making process. Each team must have a deep discussion on this aspect.
RESUMO
Plants of the family Iridaceae are well represented in the grassland vegetation of southern Brazil, occurring in the Pampa and Atlantic Forest biomes. Nevertheless, little is known about the taxonomy and evolution of Iridaceae species in southern Brazil. The main goal of this review is to compile published information about South American Iridaceae, and to discuss the evolution and genetic diversity of the family presenting our own research data in the light of the published literature. The main focus is on the genera Calydorea, Cypella, Herbertia, and Sisyrinchium. Aspects of reproductive system and of pollinator attraction are also discussed.
RESUMO
A fisioterapia dermato-funcional é fundamentada em conhecimento científico, contribuindo efetivamente durante os períodos pré e pós-operatório de cirurgias plásticas cosméticas. Este estudo teve como objetivo analisar descritivamente a frequência de encaminhamento de pacientes advindos de cirurgias plásticas à fisioterapia dermato-funcional durante os períodos pré e pós-operatório, bem como o principal critério técnico utilizado para tais encaminhamentos. Por meio de um questionário, foram entrevistados 30 médicos cirurgiões plásticos da cidade de Porto Alegre-RS. Desses, 4 (13%) relataram desconhecer a fisioterapia dermato-funcional, 10 (33%)responderam que encaminham pacientes para fisioterapia no período pré-operatório e 28 (93%), que encaminham durante o períodopós-operatório. Do total, 19 (63%) disseram realizar encaminhamento especificamente para um fisioterapeuta dermato-funcional. Observa-se, portanto, que no período pré-operatório, o encaminhamento ainda é percentualmente pouco expressivo. A divulgação da forma de atuação e o conhecimento em relação ao fisioterapeuta dermato-funcional necessitam ser aperfeiçoados.
Aesthetic physical therapy is based on scientific knowledge, effectively contributing during preoperative and postoperative periods of cosmetic plastic surgeries. This study aimed to descriptively analyze how frequently doctors recommend aesthetic physicaltherapy in preoperative and postoperative periods for patients submitted to plastic surgeries, as well as the main technical criterion usedfor such recommendations. By means of a questionnaire, 30 medical plastic surgeons of the city of Porto Alegre were interviewed. From these, 4 (13%) said to be unaware of aesthetic physical therapy, 10 (33%) had answered that they refer patients to aesthetic physicaltherapy in pre- and postoperative periods, and 28 (93%) said that they recommend this during the postoperative period. From thetotal, 19 (63%) had said to give patients instructions to aesthetic physical therapy. It is observed, therefore, that recommendations are not statistically significant in the preoperative period. The process of making more known work specificities and knowledge as regardsaesthetic physical therapy need to be perfected.
La fisioterapia dermatológico-funcional se basa en conocimientos científicos, contribuyendo con eficacia durante períodos preoperatorios y postoperatorios de cirugías plásticas cosméticas. Este estudio buscó analizar descriptivo cómo los doctores recomiendan con frecuencia la fisioterapia dermatológico-funcional en los períodos preoperativos y postoperatorios para los pacientes sometidos a las cirugías plásticas, tan bien como el criterio técnico principal usado para tales recomendaciones. Por medio de un cuestionario, 30cirujanos plásticos médicos de la ciudad de Porto Alegre fueron entrevistados. De éstos, 4 (el 13%) dijeron desconocer a la fisioterapia dermatológico-funcional en períodos pre- y postoperatorios y 28 (el 93%) dijeron que la recomiendan durante el período postoperatorio.Del total, 19 (el 63%) han dicho que fornecen a pacientes instrucciones de consultar a un fisioterapeuta dermatológico-funcionalespecializado. Se observa, por lo tanto, que las recomendaciones no son estadísticamente significativas en el período preoperativo. El trabajo de hacer conocidas las especificidades y el conocimiento del trabajo en lo que concierne a fisioterapeutas dermatológico-funcionales necesita ser perfeccionado.